Sacroiliac Joint Injections

1. What is a sacroiliac joint injection?

A sacroiliac joint injection is an injection, under X-ray guidance, of local anesthetic and steroid into the sacroiliac joint to decrease the pain associated with sacroiliac joint inflammation.

A sacroiliac joint injection may be of diagnostic or therapeutic value. One of three things will happen:

The pain does not go away, which means that the pain is probably not coming from the sacroiliac joint. This is of diagnostic value.

The pain goes away and stays away for a few hours, but it comes back and does not get better again. In this case, the block is also of diagnostic value, as it means the pain is probably coming from the sacroiliac joint, but the steroid was not of benefit.

The pain goes away after the block and may come back later that day, but it improves again over the next few days. This means that the block was of therapeutic value, because the steroid had a long lasting effect on the pain.

If you get a good, lasting benefit from the injection, it may be repeated.

Please note: This procedure cannot be performed if you have an active infection (and are on antibiotics), flu, fever, extremely high blood pressure, or if you are on blood thinners (e.g., aspirin, Coumadin, Plavix, Pletal). Blood thinners must be stopped five to seven days prior to the procedure. For your safety, please inform us if any of these conditions exists.

2. What are the risks of the procedure?

As with most procedures, there is a remote risk of bleeding, infection, nerve injury or allergic reaction to the medications used. Some short-term side effects may occur, as well. You may experience some numbness near the injection site. You may have increased pain for a few days following the injection, including localized pain at the injection site. Diabetics may have a short-term elevation of blood sugars. People prone to fluid retention may have increased fluid retention for one to two weeks.

3. What happens during the procedure?

After you check in and sign a consent form, your vital signs will be taken. Then you will be taken to the procedure room. Please wear loose-fitting clothing. You may be asked to change into a hospital gown.

In the procedure room, our nursing staff will position you on your stomach on a narrow table. Your back will be cleaned with iodine and sterilely draped. Then, the doctor will numb your skin with a small needle, which will sting just a bit. It is very important to hold still and let us know if we are causing you discomfort. Next, the doctor will use an X-ray machine (fluoroscope) to guide the needle into the correct spot. An X-ray contrast (dye) may be injected at this point. Please let the doctor know if you have an allergy to dye. Local anesthetic and steroid are then injected through the needle, and the needle is removed. Your skin will be cleaned and a bandage applied. The bandages may be removed the next morning. The procedure will last 10 to 15 minutes.

Your pain may improve immediately after the injection, due to the local anesthetic. It is important to keep track of how you feel for the next few days. The steroid usually takes two or three days to have an effect in most people, and peaks in about two weeks. It is important that you keep track of the amount of pain relief you receive, as well as how long it lasts.

4. What happens after the procedure?

You will be taken to the recovery area, where you will remain for 5 to 15 minutes. After your vital signs have been taken, you can be discharged. If you have local tenderness from the needle(s), ice may help relieve the discomfort. You can also resume taking your normal pain medications.

5. Will I have any restrictions after the procedure?

Following your procedure, you are not allowed to drive for the remainder of the day. An adult must be present to drive you home or to escort you on another form of transportation. This is for your own safety. In addition, do not go swimming or soak in a tub or Jacuzzi on the day of your procedure. Otherwise, you may do whatever you feel up to doing.

6. For what reasons should I call the Pain Management Center after the injection?

You should call us immediately at 781-744-5090 if you experience any of the following:

Severe back pain that is not relieved with medication and ice

Prolonged, new numbness or weakness of your legs

Loss of control of your bladder or bowels

Signs of infection in the area of injection

Things to Do Before the Procedure

Any dietary restrictions will be discussed on the day the procedure is booked.

Take all of your medications as scheduled on the day of the procedure, unless directed otherwise.

Think of any questions for us and write them down.

Make the nurses and doctors aware of any new changes in your medical condition.

Before you come in, let us know if you are taking any blood thinners (e.g., aspirin, Coumadin, Plavix, Pletal) or anti-inflammatories.